Eculizumab Treatment for Postpartum HELLP Syndrome and AHUS-Case Report

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2020 Apr 21

PMID 32308654

Citations 7

Authors

A Inkeri Lokki

Mikko Haapio

Jenni Heikkinen-Eloranta

Affiliations

Soon will be listed here.

Abstract

Preeclampsia is a pregnancy-specific disorder affecting ca 3% of all pregnant women. Preeclampsia is the source of severe pregnancy complications. Later life consequences for mother and infant include increased risk of cardiovascular disease. Preeclampsia is caused by the dysfunction of the endothelium with subsequent activation of complement and coagulation systems. HELLP syndrome is considered to be an extreme complication of preeclampsia but it can also present independently. Diagnostic symptoms in HELLP syndrome are Hemolysis, Elevated Liver enzymes, and Low Platelets. Similar phenotype is present in thrombotic microangiopathies (TMAs) and HELLP syndrome is considered part of the TMA spectrum. Here, we present a case of severe preeclampsia and HELLP syndrome, which exacerbated rapidly and eventually led to need of intensive care, plasma exchange, and hemodialysis. The patient showed signs of hemolysis, disturbance in the coagulation, and organ damage in liver and kidneys. After comprehensive laboratory testing and supportive care, the symptoms did not subside and treatment with complement C5 inhibitor eculizumab was started. Thereafter, the patient started to recover. The patient had pregnancy-induced aHUS. Earlier initiation of eculizumab treatment may potentially shorten and mitigate the disease and hypothetically decrease future health risks of preeclamptic women.

Citing Articles

Pregnancy associated atypical hemolytic uremic syndrome presenting with preeclampsia with HELLP syndrome and following treatment with Eculizumab.

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Circulating extracellular vesicles and neutrophil extracellular traps contribute to endothelial dysfunction in preeclampsia.

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Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review.

Janoudi G, Uzun Rada M, Boyd S, Fell D, Ray J, Foster A Int J Womens Health. 2023; 15:411-425.

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